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1.
Clin Case Rep ; 7(12): 2321-2326, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31893050

RESUMO

In renal tumors, suspicious for renal cell carcinoma, where there is any doubt and discrepancy between morphology and immune profile, we recommend performing further immunohistochemical staining for pan-cytokeratin, S100, NSE, and inhibin-alpha. Thus, follow-up overtreatment can be avoided in cases of benign kidney tumors.

2.
Case Rep Urol ; 2015: 701046, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25852958

RESUMO

Spontaneous, nontraumatic retroperitoneal hemorrhage or Wunderlich syndrome (WS) is a rare but potential life-threatening condition. In most patients a bleeding renal neoplasm is the cause of the retroperitoneal hematoma. The management of this condition includes a conservative approach in the hemodynamically stable patients and active treatment in the unstable patients. Active treatment includes angioembolization or surgery. If angioembolization is not available open surgery is in most cases the preferred approach. We present a patient with a spontaneously ruptured kidney due to a central renal angiomyolipoma, which was treated by laparoscopic nephrectomy.

3.
J Urol ; 184(3): 913-7, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20643432

RESUMO

PURPOSE: We assessed the prostate cancer detection rate of real-time elastography targeted biopsy in men with total prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less. MATERIALS AND METHODS: Real-time elastography using an EUB 8500 Hitachi ultrasound system (Hitachi Medical, Tokyo, Japan) was done in 94 men with a mean age of 57.4 years (range 35 to 77) with increased prostate specific antigen between 1.25 ng/ml or greater and 4.00 ng/ml or less (mean 3.20, range 1.30 to 4.00) and a free-to-total prostate specific antigen ratio of less than 18%. Real-time elastography was done to evaluate peripheral zone tissue elasticity and hard areas were defined as suspicious. Targeted biopsies with a maximum of 5 cores were done in suspicious areas, followed by 10-core systematic biopsy. We analyzed the cancer detection rate of real-time elastography and systematic biopsy. RESULTS: Cancer was found in 27 of 94 patients (28.7%). Real-time elastography detected cancer in 20 patients (21.3%) and systematic biopsy detected it in 18 (19.1%). Positive cancer cores were found in real-time elastography targeted cores in 38 of 158 cases (24%) and in systematic cores in 38 of 752 (5.1%) (chi-square test p <0.0001). The cancer detection rate per core was 4.7-fold greater for targeted than for systematic biopsy. CONCLUSIONS: Real-time elastography targeted biopsy allows prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4 ng/ml or less with a decreased number of cores compared with that of systematic biopsy.


Assuntos
Técnicas de Imagem por Elasticidade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Biópsia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
4.
Eur Radiol ; 20(12): 2791-6, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20571801

RESUMO

OBJECTIVE: To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men. METHODS: Retrospective, single-centre, diagnostic accuracy study from 2002 until 2006 in 1,776 male volunteers with a serum total PSA of 1.25 ng/ml or greater. In each patient five CECD-US targeted biopsies were performed in hypervascular areas in the peripheral zone during intravenous injection of a second-generation microbubble US contrast agent. Subsequently, another examiner performed ten SBs. The PCa detection rates for the two techniques were compared. RESULTS: Of 1,776 patients, cancer was detected in 559 patients (31%), including 476 of the 1,776 patients (27%) with CECD-US and 410 (23%) with SB (p < 0.001). The detection rate for CECD-US targeted biopsy cores (10.8% or 961 of 8,880 cores) was significantly better than for SB cores (5.1% or 910 of 17,760 cores, p < 0.001). Among patients with a positive biopsy for PCa, cancer was detected by CECD-US alone in 149 patients (27%) and by SB alone in 83 (15%) (p < 0.001). CONCLUSION: This study represents the largest clinical trial to date, demonstrating a significant benefit of CECD-US targeted biopsy relative to SB.


Assuntos
Biópsia por Agulha/estatística & dados numéricos , Fosfolipídeos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Hexafluoreto de Enxofre , Ultrassonografia Doppler em Cores/métodos , Ultrassonografia de Intervenção/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Meios de Contraste , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
5.
BJU Int ; 106(8): 1211-4, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20230383

RESUMO

OBJECTIVE: to report a new dorsal labia minora skin-graft urethroplasty as a simple, safe and effective therapeutic alternative for female urethral strictures, as although distal urethral strictures can be treated by meatoplasty, proximal and mid-urethral strictures need appropriate urethroplasty. PATIENTS AND METHODS: eight women with a confirmed proximal or mid-urethral stricture had indications for urethroplasty with the use of a thin free labia minora skin graft using a dorsal (6 o'clock position) urethroplasty technique. Full informed consent was obtained. From the inner aspect of one labium minora a thin free skin flap was prepared. The strictured urethra and the anterior vaginal wall were transected and the graft sutured into the defect. All scar tissue was removed and the anterior vaginal wall closed in two layers over the area of the urethroplasty. Continence was evaluated by a stress test with a full bladder. RESULTS: all patients were operated on with no complications during or after surgery. After 1 and 2 years of follow-up seven and six of the eight patients had no recurrence of stricture disease. All patients remained continent. CONCLUSION: the urethroplasty using an inlay of free thin genital skin graft was safe, uncomplicated and effective.


Assuntos
Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Uretra/cirurgia , Estreitamento Uretral/cirurgia , Vulva/transplante , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Procedimentos de Cirurgia Plástica/efeitos adversos , Transplante de Pele , Resultado do Tratamento
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